Fourteen years since Californians passed the first-in-the-nation medical marijuana law, pot is not just for the sick. Hundreds of medical marijuana doctors, operating without official scrutiny, have helped make it available to nearly anyone who wants it.

They are practicing a lucrative and thriving specialty, becoming the linchpins of a billion-dollar industry. And yet they do not have to report to whom they recommend the drug, how many referrals they give or for what ailments.

“There is something inappropriate about doctors being the gatekeepers,” said Timmen Cermak, president of the California Society of Addiction Medicine. “They are secretaries here … All they are doing is telling the police to keep their hands off.”

As voters go to the polls today to decide if they want California to be the first to legalize recreational pot use and sales, the medical marijuana system they helped establish in 1996 has effectively become a legal cover to smoke pot.

The system also stands as a cautionary example for other states crafting their own laws. Among them are Arizona and South Dakota, which have medical marijuana on today’s ballot.

Under California’s law, medical doctors and osteopaths can recommend the drug for any illness “for which marijuana provides relief,” a category that has come to encompass conditions such as alcoholism, anxiety, asthma and insomnia.

Obtaining approval in the other 13 states that allow pot for medical use is far more difficult.

Those states limit the drug to residents suffering from one or more specific serious conditions, such as AIDS or cancer. Most require patients to register, creating a paper trail for tracking both users and their physicians.

In California, however, there is no central database to track doctors or patients. Beyond a medical license, the pot physicians do not need to have any relevant training, familiarity with the scientific literature on pot’s benefits and side-effects or special certification.

They can simply hang a shingle, and start practicing.

There are more than 100,000 licensed doctors in the state, and medical marijuana advocates estimate that roughly 1,500 of them have recommended pot to at least one patient.

Of those, advocates say, 400 to 500 doctors account for the majority of recommendations.

To identify them, The Associated Press scoured online directories maintained by marijuana advocacy groups; ads in alternative weeklies and pot-themed periodicals; and clinic websites. Interviews with clinic managers or doctors who own the clinics provided additional names.

The AP’s list of 233 doctors is not exhaustive, nor can it be, given the lack of information with the state.

An analysis of the names and state medical board files showed that most marijuana doctors on the list have clean records.

But there were also 68 physicians who have run afoul of regulators. Some of the disciplinary actions against them included fraud, misprescribing drugs, abusing prescription or illicit drugs themselves, as well as and negligence.